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Endoscopy Inflammatory bowel

Ryan Ichikawa, Christopher A Lamb, Jeff Eastham-Anderson, Alexis Scherl, Laura Raffals, William A Faubion, Miriam R Bennett, Anna K Long, John C Mansfield, John A Kirby, Mary E Keir
Background: Recent findings suggest that αE expression is enriched on effector T cells and that intestinal αE+ T cells have increased expression of inflammatory cytokines. αE integrin expression is a potential predictive biomarker for response to etrolizumab, a monoclonal antibody against β7 integrin that targets both α4β7 and αEβ7. We evaluated the prevalence and localisation of αE+ cells as well as total αE gene expression in healthy subjects and inflammatory bowel disease patients...
June 15, 2018: Journal of Crohn's & Colitis
Dario Sorrentino, Vu Q Nguyen
Background: In Crohn's disease (CD) a small bowel study-in addition to colonoscopy-is considered necessary for diagnosis/staging. In this study we re-examined the role of capsule endoscopy (CE), colonoscopy, imaging tests [magnetic resonance enterography/computed tomographic enterography (MRE/CTE)], and inflammatory markers [fecal lactoferrin and C-reactive protein (FL/CRP)] in CD patients who had undergone intestinal resection and in those who never had surgery. Methods: In this retrospective study 43 consecutive patients underwent CE because of staging/symptoms unexplained by colonoscopy/imaging...
June 8, 2018: Inflammatory Bowel Diseases
Sara Ebrahimi, Gholamreza Khademi, Seyed Ali Jafari, Nona Zaboli Nejad, Abdolreza Norouzy, Bahareh Imani
Very-early-onset inflammatory bowel disease (VEO-IBD) has a distinct phenotype and should be considered a specific entity. VEO-IBD presents with very severe clinical pictures and is frequently known by an indeterminate colitis whose clinical remission is unmanageable. This study examines the case of a neonate with VEO-IBD, not responding to medical and surgical treatment. A 7-day-old Iranian female neonate presented with severe bloody diarrhea, poor feeding, abdominal distention, and dehydration suggesting severe proctocolitis due to an allergy to the protein in cow's milk...
May 2018: Iranian Journal of Medical Sciences
Jiao Li, Wai K Leung
Colon capsule endoscopy (CCE) is designed for direct visualization of the colonic mucosa through passive propulsion. The role of CCE on detection of colonic polyps has been extensively evaluated. As mucosal healing has emerged as a pivotal target for treatment of inflammatory bowel disease (IBD), there is increasing data to suggest that CCE can also be used in the monitoring of mucosal inflammation in patients with active IBD, particularly in ulcerative colitis (UC) and also in Crohn's disease (CD). Despite advantages such as its non-invasive nature, patient's comfort, safety, and access to anatomical regions not easily reached by conventional endoscopy, CE has limitations including the lack of ability to obtain biopsies or therapeutic capabilities and no control over movement...
June 4, 2018: Journal of Digestive Diseases
Reena Khanna, Neeraj Narula, Brian G Feagan
Clinical trials require valid outcome measures to assess the therapeutic benefit of investigational agents. Recently, regulatory authorities have mandated the use of patient-reported outcomes in combination with an objective measure of disease activity as primary outcome measures in inflammatory bowel disease trials. Endoscopy has commonly fulfilled the latter role; however, due to the costs and complexity of these assessments, interest has emerged in the use of noninvasive biomarkers. The role of C-reactive protein, fecal calprotectin, and fecal lactoferrin in clinical research is discussed...
May 28, 2018: Inflammatory Bowel Diseases
Naoki Hosoe, Masaru Nakano, Ken Takeuchi, Yutaka Endo, Katsuyoshi Matsuoka, Takayuki Abe, Teppei Omori, Mari Hayashida, Taku Kobayashi, Atsushi Yoshida, Shinta Mizuno, Nakazato Yoshihiro, Makoto Naganuma, Takanori Kanai, Mamoru Watanabe, Fumiaki Ueno, Yasuo Suzuki, Toshifumi Hibi, Haruhiko Ogata
Background: The usefulness of second-generation colon capsule endoscopy (CCE-2) for ulcerative colitis (UC) has not been fully demonstrated. This study aimed to develop an endoscopic severity score of UC for CCE-2. Methods: Patients diagnosed with UC were enrolled prospectively and underwent colonoscopy and CCE-2 on the same day. The collected CCE-2 videos were adopted for the development of the score. These videos were scored by 4 blinded inflammatory bowel disease experts...
May 26, 2018: Inflammatory Bowel Diseases
Genta Furuya, Hiroyuki Abe, Aya Shinozaki-Ushiku, Aya Yamashita, Sozaburo Ihara, Yoshihiro Hirata, Akira Chiba, Yosei Fujioka, Mineo Kurokawa, Kazuhiko Koike, Masashi Fukayama
Extranodal NK/T cell lymphoma, nasal type (ENKL) developed in a patient with intestinal Epstein-Barr virus (EBV)-positive T/NK-cell lymphoproliferative disorder (LPD). The patient was a 46-year-old Chinese man who complained of diarrhea and abdominal pain without immune-deficiency. Endoscopy demonstrated ileum ulcers like Crohn's disease, without histological granulomas. His symptoms continued waxing and waning for 3 years until he developed overt lymphoma (ENKL) in the nasal cavity. The ileum lesions exacerbated into a large deep ulcer, and the biopsy specimens from the ileum, including the one 3 years ago, showed infiltration of small lymphocytes containing many EBV-positive T/NK cells without atypia...
May 22, 2018: Pathology, Research and Practice
Yidong Yang, Xianyi Lin, Siwei Tan, Xiaoli Huang, Zijun Xie, Xuan Xu, Yiming Lei, Bin Wu
Objective: Diagnostic colonoscopy is important for diagnosing colorectal diseases, including inflammatory bowel disease and colorectal tumours. Perforation during diagnostic colonoscopy, a rare but serious complication, is a considerable factor before performing the procedure. Immediate endoluminal closure of a perforation could prevent the adverse consequences associated with general anaesthesia and surgery. This study is aimed at assessing the potential effectiveness and safety of endoscopic band ligation (EBL) in closing a colon perforation during endoscopy in a porcine model...
2018: Gastroenterology Research and Practice
Romano Schneider, Marko Kraljević, Markus von Flüe, Ida Füglistaler
Introduction: Rectal mucoceles rarely occur and only a few cases are described in the literature. They usually appear after subtotal colectomy or Hartmann procedure originating from persisting rectal mucus production and simultaneous stenosis of the anal canal. Case Presentation: A 74-year-old female patient presented with the feeling of an abdominal growing mass. Complex medical history included a subtotal colectomy with an end ileostomy and a mucous fistula at the descending colon due to Crohn disease at the age of 16 years...
January 2018: Case Reports in Gastroenterology
Jung H Suh, Émilie Degagné, Elizabeth E Gleghorn, Mala Setty, Alexis Rodriguez, K T Park, Sofia G Verstraete, Melvin B Heyman, Ashish S Patel, Melissa Irek, Ginny L Gildengorin, Neil E Hubbard, Alexander D Borowsky, Julie D Saba
Goal: The aim of this study was to investigate gene expression levels of proteins involved in sphingosine-1-phosphate (S1P) metabolism and signaling in a pediatric inflammatory bowel disease (IBD) patient population. Background: IBD is a debilitating disease affecting 0.4% of the US population. The incidence of IBD in childhood is rising. Identifying effective targeted therapies that can be used safely in young patients and developing tools for selecting specific candidates for targeted therapies are important goals...
May 18, 2018: Inflammatory Bowel Diseases
Shishira Bharadwaj, Neeraj Narula, Parul Tandon, Mohammad Yaghoobi
Crohn's disease (CD) and ulcerative colitis (UC) constitute the two most common phenotypes of inflammatory bowel disease (IBD). Ileocolonoscopy with biopsy has been considered the gold standard for the diagnosis of IBD. Differential diagnosis of CD and UC is important, as their medical and surgical treatment modalities and prognoses can be different. However, approximately 15% of patients with IBD are misdiagnosed as IBD unclassified due to the lack of diagnostic certainty of CD or UC. Recently, there has been increased recognition of the role of the therapeutic endoscopist in the field of IBD...
May 2018: Gastroenterology Report
Kara Robertson, Stephen Couban, Desmond Leddin, Imran Ahmad, Lori Connors
Background: Chronic granulomatous disease (CGD) is a rare primary immunodeficiency characterized by recurrent life-threatening bacterial and fungal infections, granuloma formation and intestinal disease. This disease is caused by defects in NADPH oxidase, which result in the inability of phagocytes (neutrophils, monocytes and macrophages) to destroy certain microbes. The only established curative therapy for CGD is hematopoietic stem cell transplantation. Case presentation: A 23-year-old Caucasian male with X-linked chronic granulomatous disease underwent a reduced-intensity conditioning, matched unrelated donor peripheral blood stem cell transplant, after which he was started on tacrolimus and mycophenolate for graft-versus-host disease prophylaxis...
2018: Allergy, Asthma, and Clinical Immunology
Ali S Taha, Caroline McCloskey, Paula McSkimming, Alex McConnachie
BACKGROUND: The incidence of obscure gastrointestinal bleeding, which originates from the small bowel and is mainly associated with the use of aspirin and non-steroidal anti-inflammatory drugs (NSAIDs), is rising. We assessed the efficacy and safety of misoprostol for the treatment of small bowel ulcers and erosions in patients taking low-dose aspirin or NSAIDs with obscure gastrointestinal bleeding. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients (aged ≥18 years) with small bowel ulcers who were taking low-dose aspirin, NSAIDs, or both for a minimum of 4 weeks, at University Hospital Crosshouse (Kilmarnock, UK)...
May 10, 2018: Lancet. Gastroenterology & Hepatology
Joyce Lok Gee Ma, Paul Norman Strauss
INTRODUCTION: Small bowel malignancies are rare and often present with non-specific symptoms. Because of this, diagnosis of small bowel malignancies is often missed. PRESENTATION OF CASE: 71-year-old male presented with a four-week history of right iliac fossa pain and loss of weight. Laboratory tests showed a raised C-reactive protein, but all other pathology results and tumour-associated antigens were normal. Computed tomography (CT) of the abdomen demonstrated an inflammatory mass extending laterally into the pelvic wall...
April 27, 2018: International Journal of Surgery Case Reports
Lieven Pouillon, Valérie Laurent, Marc Pouillon, Peter Bossuyt, Christiana Bonifacio, Silvio Danese, Parakkal Deepak, Edward V Loftus, David H Bruining, Laurent Peyrin-Biroulet
Cross-sectional MRI is an attractive alternative to endoscopy for the objective assessment of patients with inflammatory bowel disease (IBD). Diffusion-weighted imaging is a specialised technique that maps the diffusion of water molecules in biological tissues and can be done without intravenous gadolinium contrast injection. Diffusion-weighted imaging further expands the capability of traditional MRI sequences in IBD. However, the use of quantitative parameters, such as the apparent diffusion coefficient, is limited by low reproducibility...
June 2018: Lancet. Gastroenterology & Hepatology
Chun-Seok Yang, Ji Y Park, Hye Ryeon Choi, Daedong Kim
Multiple strictures of small bowel induced by nonsteroidal anti-inflammatory drugs (NSAIDs), were known as diaphragm disease. The purpose of these case reports is to present 3 cases of diaphragm disease of small bowel and summarize the clinical features of this disease entity. A 34-year-old man, a 63-year-old man, and a 66-year-old woman were admitted to Daegu Catholic University Medical Center because of recurrent intestinal obstructions. Two of these patients had taken heavy NSAIDs use. Capsule endoscopy was performed in all cases and the all capsules were retained by circumferential strictures of the ileum...
May 2018: Annals of Surgical Treatment and Research
Andreea Marin, Laura Tribus, Carmen Fierbinteanu-Braticevici
Inflammatory bowel diseases have an important impact upon the economic and social status due to their increasing incidence and prevalence, often affecting young people. At the moment, the therapeutic goal goes beyond the improvement of symptoms and laboratory parameters, being represented by endoscopic mucosal healing, changing the disease's natural history. Even though endoscopy is the gold standard for the assessment of mucosal healing, it is an invasive maneuver and it lacks good repeatability. These patients require frequent evaluation; therefore, interest for noninvasive techniques has risen...
May 2, 2018: Medical Ultrasonography
Xinying Wang, Bo Shen
Fecal diversion with ostomy construction can be a temporary or definitive surgical measure for the treatment of refractory inflammatory bowel disease (IBD). However, the fecal diversion surgery is associated with various stoma, peristomal complications, and recurrence or occurrence of de novo small bowel Crohn's disease (CD). Stoma complications often need enterostomal therapy or surgical revision. Peristomal cutaneous lesions, such as pyoderma gangrenosum, usually require immunomodulator or biological therapy...
May 2, 2018: Inflammatory Bowel Diseases
Sara Monteiro, Mara Barbosa, Tiago Cúrdia Gonçalves, Pedro Boal Carvalho, Maria João Moreira, Bruno Rosa, José Cotter
Background: Small bowel capsule endoscopy (SBCE) is a firstline examination in patients with suspected Crohn's disease (CD) after negative ileocolonoscopy. Fecal calprotectin (FC) is a noninvasive marker of intestinal inflammation. The aim of this study was to evaluate the predictive value of FC in inflammatory activity detected by SBCE in patients with suspected CD. Methods: This is a retrospective study including patients who underwent SBCE for suspected CD between March 2015 and October 2016...
May 2, 2018: Inflammatory Bowel Diseases
Anthony K Akobeng
AIM: The faecal calprotectin (FC) test is increasingly being used in clinical practice to help select children with gastrointestinal symptoms who might have inflammatory bowel disease (IBD) and benefit from endoscopies. We provide an overview of the advantages and limitations of the FC test. METHODS: PubMed was searched for meta-analyses that had investigated the diagnostic accuracy of the FC test and the pooled sensitivity and specificity for distinguishing IBD from non-IBD patients were used to calculate likelihood ratios (LR)...
April 29, 2018: Acta Paediatrica
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